Optimal β-blocker for prevention of atrial fibrillation after on-pump coronary artery bypass graft surgery: Carvedilol versus metoprolol

Background: Atrial fibrillation (AF) is the most common arrhythmia after coronary artery bypass graft (CABG) surgery. It has been shown that prophylactic oral β-blocker administration reduces the incidence of post-CABG AF. However, the optimal β-blocker has not been identified. Objective: This study sought to determine whether oral carvedilol (with its unique anti-inflammatory and antioxidant properties) is more effective than oral metoprolol for prevention of AF after CABG surgery. Methods: Between April 2006 and December 2006, 120 patients (63 men, mean age 61 ± 9.4 years) who were scheduled to undergo their first on-pump CABG were enrolled in this study. The patients were randomized in a prospective 1:1 manner to receive either oral carvedilol (n = 60) or oral metoprolol (n = 60). The end point of the study was the occurrence of the new-onset AF during the first 5 days aftere CABG. Results: AF occurred in 29 of 120 patients (24.0). The incidence of postoperative AF was 15.0 (9 of 60) in the carvedilol group and 33 (20 of 60) in the metoprolol group (P = .022). The carvedilol group was treated with mean daily dose of 46 ± 9 mg and metoprolol group with mean daily dose of 93 ± 11 mg. There were no differences between the study groups regarding any known preoperative, perioperative, or postoperative characteristics (all values were P >.05). No significant adverse effect was observed in either group. Conclusion: This prospective study suggested that oral carvedilol is more effective than oral metoprolol in the prevention of AF after on-pump CABG. It is well tolerated when started before and continued after the surgery. However, further prospective studies are needed to clarify this issue. © 2007 Heart Rhythm Society

The key role of Akt protein kinase in metabolic-inflammatory pathways cross-talk: TNF-alpha down-regulation and improving of insulin resistance in HepG2 cell line

BACKGROUND: Elevation of plasma free fatty acids as a principal aspect of type 2 diabetes maintains etiologically insulin insensitivity in target cells. TNF-alpha inhibitory effects on key insulin signaling pathway elements remain to be verified in insulin-resistant hepatic cells. Thus, TNF-alpha knockdown effects on the key elements of insulin signaling were investigated in the palmitate-induced insulin-resistant hepatocytes. The Akt serine kinase, a key protein of the insulin signaling pathway, phosphorylation was monitored to understand the TNF-alpha effect on probable enhancing of insulin resistance. METHODS: Insulin-resistant HepG2 cells were produced using 0.5 mM palmitate treatment and shRNA-mediated TNF-alpha gene knockdown and its down-regulation confirmed using ELISA technique. Western blotting analysis used to assess the Akt protein phosphorylation status. RESULTS: Palmitate-induced insulin resistance caused TNF-alpha protein overexpression 1.2-, 2.78, and 2.25- fold as compared to the control cells at post-treatment times of 8 h, 16 h, and 24 h, respectively. In the presence of palmitate, TNF-alpha expression showed around 30 reduction in TNF-alpha knockdown cells as compared to normal cells. In the TNF-alpha down-regulated cell, Akt phosphorylation was approximately 62 more than control cells after treatment with 100 nM insulin in conjugation with 0.5 mM palmitate. CONCLUSIONS: The obtained data demonstrated that TNF-alpha protein expression reduction improved insulin-stimulated Akt phosphorylation in the HepG2 cells and decreased lipid-induced insulin resistance of the diabetic hepatocytes

Epidemiological study of acute food poisoning recorded at Imam Khomeini Hospital of Kermanshah during 4 years period (2008-2011)

Foodborne diseases remain as one of the world’s major health problem that often poses severe and immediate danger. Epidemiological studies have essential role in identifying the contamination sources, transmission routes and prevalence rates of foodborne diseases, as well as establishing the prevention/control strategies. The aim of this study was to conduct an epidemiological survey on acute foodborne diseases recorded at Imam Khomeini Hospital of Kermanshah during 4 years (2008-2011). For this, the information of patients was extracted using 165 medical files. Using Chi-Square test, the relationship between the occurrence of foodborne diseases and different variables was determined. Considering the season, gender and age of the patients, it was revealed that most incidences of foodborne diseases were observed in spring, male patients and age group of 15 to 30 years. The incidence trend of foodborne diseases was increased from 2008 to 2011. Moreover, there were a significant relationship among incidence of foodborne diseases with season, month, gender and age group (P < 0.01). According to the results it is crucial that the responsible authorities bring about the public educations to increase the public awareness using radio, TV shows, newspapers, and etc